Objective: To evaluate the efficacy and compliance of long-acting injectable antipsychotics (LAIA) in schizophrenia patients under the community-based health management model, and to analyze the compliance influencing factors, so as to provide a scientific basis for optimizing the application of LAIA in community.

Methods: Schizophrenia patients who were evaluated by psychiatrists as suitable for LAIA treatment in Shanghai Changning District Mental Health Center from July 1, 2021 to June 30, 2022 were selected as the subjects. At the start of treatment and after 1 year of treatment, all enrolled schizophrenia patients underwent personal clinical characteristic assessments using Family Burden Scale (FBS), World Health Organization Quality of Life-Brief Scale (WHOQOL-BREF), Social Disability Screening Schedule (SDSS), Brief Psychiatric Rating Scale (BPRS) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS). The differences in the scores of the scales before and after LAIA treatment were analyzed by paired-samples rank-sum test, the differences in the scores of the scales among schizophrenia patients with different compliance were analyzed by the independent-samples rank-sum test. The χ² test was used to analyze the differences in baseline clinical characteristics among schizophrenia patients with different compliance, and multivariable logistic regression was used to analyze the factors influencing the compliance of schizophrenia patients receiving LAIA treatment.

Results: This study included a total of 116 patients with schizophrenia, of whom 79 (68.1%) had good compliance and 37 (31.9%) had poor compliance. There were statistically significant differences in occupational status, source of medical expenses, family supervision, social participation, and previous hospitalization frequency between the good compliance group and the poor compliance group (all P<0.05). After one year of LAIA treatment, the scores of FBS, WHOQOL-BREF, BPRS, and CRDPSS for schizophrenia patients showed significant differences compared to those before treatment (all P<0.05). Source of medical expenses, previous hospitalization frequency, and social participation were independent factors affecting the compliance of schizophrenia patients receiving LAIA treatment (all P<0.05).

Conclusion: Under the community health management model, LAIA can effectively improve the psychiatric symptoms of schizophrenia patients, enhance their quality of life, and reduce their family burden, and while enhance their compliance, but some patients still face issues with poor compliance. In future community health management practices, measures such as strengthening the responsibility of caregivers, encouraging patients to actively participate in social activities, and reducing the rate of disease recurrence and re-hospitalization can be taken to optimize the LAIA treatment in community. This will further improve the compliance and overall efficacy of LAIA treatment for schizophrenia patients in community, thereby facilitating their better integration into society.